Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study

Da Young Lee, Jaeyoung Kim, Sanghyun Park, So Young Park, Ji Hee Yu, Ji A. Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Kyungdo Han, Nan Hee Kim

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: We investigated whether fasting glucose (FG) variability could predict the risk of dementia. Methods: This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which included at least one examination between 2009 and 2010. A total of 769,554 individuals were included, excluding those aged <40 years and those with dementia. FG variability was measured using the variability independent of the mean (FG-VIM). The incidence of dementia was defined by the International Classification of Diseases 10th Revision codes and prescription of anti-dementia medication and was subdivided into Alzheimer’s disease (AD) and vascular dementia (VD). Results: During the 6.9-year follow-up, 54,837, 41,032, and 6,892 cases of all-cause dementia, AD, and VD, respectively, were identified. Cox proportional regression analyses showed that as the FG-VIM quartile increased, the risk of dementia serially increased after adjustment for metabolic factors, income status, and diabetes-related characteristics, including the mean FG. Participants in FG-VIM quartile 4 showed a 18%, 19%, and 17% higher risk for all-cause dementia, AD, and VD, respectively, than those in quartile 1; this particularly included non-obese patients with a longer duration of diabetes, high FG levels, dyslipidemia, and those taking glucose-lowering medications. Conversely, the baseline FG status and dementia showed a U-shaped association. Conclusion: Increased FG variability over 5 years can predict the risk of dementia in individuals with diabetes in Korea. This finding was more pronounced in patients with less favorable metabolic profiles.

Original languageEnglish
Pages (from-to)923-935
Number of pages13
JournalDiabetes and Metabolism Journal
Volume46
Issue number6
DOIs
Publication statusPublished - 2022 Nov

Bibliographical note

Funding Information:
This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (NRF-2019-M3E5D3073102 and NRF-2019R1H1A2039682), a Korea University Grant (K1810951), the Basic Science Research Program through NRF funded by the Ministry of Education (NRF-2020R1I1A1A01071665), and a Korea University Ansan Hospital grant (O2000291). However, the funders did not participate in study design or reporting.

Publisher Copyright:
Copyright © 2022 Korean Diabetes Association.

Keywords

  • Alzheimer disease
  • Dementia
  • Dementia, vascular
  • Diabetes mellitus
  • Glucose

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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